Sena Kim-Reuter, the president and sole employee of a recently launched nonprofit called the Mount Sinai Medical-Legal Partnership, is on a mission to enlist pro bono lawyers to address the pressing legal needs of the health system's most vulnerable patients.
Before agreeing to run the nonprofit, which was set up by a legal clinic at Columbia Law School and is run independently of the health system, Kim-Reuter was unaware of the growing national movement to build medical-legal partnerships.
"Instead of fixing someone's legal issue to correct a social injustice, you can also look at it as a way to improve their health and well-being," Kim-Reuter said.
The Mount Sinai partnership was formed in June 2016, but spent months identifying patients' most pressing legal needs and had its official kickoff Wednesday evening. It's still looking for pro bono attorneys to participate.
Medical-legal partnerships are becoming increasingly common in the U.S., with 155 hospitals, 139 health centers and 34 health schools participating in them, according to the National Center for Medical Legal Partnership, launched in 2006 by the Milken Institute School of Public Health at George Washington University.
Such partnerships are common in New York, as well, with some linking multiple health care providers and legal organizations and others facilitating one-on-one partnerships. When the partnerships spread their services among many providers, however, resources can be scarce, said Beth Essig, executive vice president and general counsel of Mount Sinai Health System.
Prior to the launch of the Mount Sinai Medical-Legal Partnership, the health system was already a beneficiary of LegalHealth, a division of the New York Legal Assistance Group, which provides free legal services to low-income New Yorkers at city hospitals. The group handled more than 7,000 new legal matters for patients in 2016, according to its website, but, Essig said, Mount Sinai's need still was not met.
"We've gotten so big and they can only provide so much," Essig said.
So far, the Mount Sinai Medical-Legal Partnership is primarily funded by individual donors and has sparse resources as well, Kim-Reuter said. To start, it's connecting lawyers to patients at three facilities: the Center for Transgender Medicine and Surgery, Mount Sinai St. Luke's Child and Family Services and Mount Sinai's Palliative Care Services.
The partnership has already helped transgender patients change their legal names and genders, Kim-Reuter said. In the future, she said, it will likely also help them contest Medicaid denials of coverage for procedures such as facial feminization. The nonprofit also received $1.3 million from the Manhattan district attorney's office to provide legal services to families at St. Luke's whose children are not getting the educational support they need for behavioral health issues.
Kim-Reuter is finding that the legal services in greatest demand are not always the ones she expected. With palliative-care patients, she said, "I thought it was going to be wills, end-of-life planning." As it turns out, the most pressing need in palliative care is for attorneys who can provide custody services to the dying single parents of minor children.
In the future, Kim-Reuter said, she hopes to identify the legal needs of super-utilizers of the health system and measure whether addressing those needs leads to better health outcomes.
"That involves data analysis and researchers," she said. "We need real funding for that."
"New nonprofit hooks Mount Sinai's most vulnerable patients up with lawyers" originally appeared in Crain's New York Business.
